A Foodborne Outbreak of Brucellosis at a Police Station Cafeteria, Lima, Peru

Karina Román Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Rosa Castillo Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Robert H. Gilman Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Maritza Calderón Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Aldo Vivar Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Manuel Céspedes Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Henk L. Smits Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Paolo Meléndez Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Eduardo Gotuzzo Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Humberto Guerra Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Ryan C. Maves Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Michael A. Matthias Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Joseph M. Vinetz Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Mayuko Saito Department of Molecular and Cellular Sciences, Faculty of Sciences, and Laboratory of Research and Development, Universidad Peruana Cayetano Heredia, Lima, Perú; United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Asociación Benéfica PRISMA, Lima, Perú; Hospital Nacional Arzobispo Loayza, Perú; Instituto Nacional de Salud, Lima, Perú; KIT Biomedical Research, Royal Tropical Institute/Koninklijk Instituut voor de Tropen (KIT), Amsterdam, The Netherlands; Instituto de Medicina Tropical Alexander von Humboldt, Universidad Peruana Cayetano Heredia University, Lima, Perú; Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, California; Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, California

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Brucella melitensis is highly infectious for humans and can be transmitted to humans in a number of epidemiological contexts. Within the context of an ongoing brucellosis surveillance project, an outbreak at a Peruvian police officer cafeteria was discovered, which led to active surveillance (serology, blood culture) for additional cases among 49 police officers who had also eaten there. The cohort was followed up to 18 months regardless of treatment or symptoms. Active surveillance estimated the attack rate at 26.5% (13 of 49). Blood cultures from four cases were positive; these isolates were indistinguishable using multiple locus variable number tandem repeat analysis. This investigation indicates the importance of case tracking and active surveillance for brucellosis in the context of potential common source exposure. These results provide rationale for public health investigations of brucellosis index cases including the bioterrorism-related dissemination of Brucella.

Author Notes

* Address correspondence to Joseph M. Vinetz, 9500 Gilman Drive, Mail Code 0640, La Jolla, CA 92093. E-mail: jvinetz@ucsd.edu

Financial support: This study was funded by a Cooperative Agreement from the United States Public Health Service, National Institutes of Health, National Institute of Allergy and Infectious Diseases (U01AI075420).

Disclosure: R. Castillo is an employee of the U.S. Government and R. Maves is a military service member. This work was prepared as part of their official duties. Title 17 U.S.C. §105 provides that “Copyright protection under this title is not available for any work of the United States Government.” Title 17 U.S.C. §101 defines a U.S. Government work as a work prepared by a military service member or employee of the U.S. Government as part of that person's official duties.

Authors' addresses: Karina Román and Maritza Calderón, Universidad Peruana Cayetano Heredia, Department of Microbiology, Faculty of Sciences and Philosophy, Lima, Perú, E-mails: karitaroman@gmail.com and mmcalderons@yahoo.es. Paolo Meléndez, A.B. PRISMA - Biomedical research unit, Lima, Peru, E-mail: dantepao@hotmail.com. Rosa Castillo, NAMRU-6, Microbiology, Lima, Perú, E-mail: Rosa.Castillo@med.navy.mil. Robert H. Gilman, Johns Hopkins University, International Health, Baltimore, MD, E-mail: rgilman@jhsph.edu. Aldo Vivar, Hospital Macional Arzobispo Loayza — Medicine, Lima, Perú, E-mail: avivar@prisma.org.pe. Manuel Céspedes, Instituto Nacional de Salud, Diagnostic Laboratories, Lima, Perú, E-mail: manuel.cespedesz@gmail.com. Henk L. Smits, Royal Tropical Institute, Kit Biomedical Research, Amsterdam, The Netherlands, E-mail: h.smits@kit.nl. Eduardo Gotuzzo and Humberto Guerra, Universidad Peruana Cayetano Heredia, Instituto de Medicine Tropical Alexander von Humboldt, Lima, Perú, E-mails: eduardo.gotuzzo@upch.pe and humberto.guerra@upch.pe. Ryan C. Maves, United States Naval Medical Research Unit No. 6 (NAMRU-6), Lima, Perú, current affiliation: Division of Infectious Diseases, Department of Internal Medicine, Naval Medical Center, San Diego, CA, E-mail: Ryan.Maves@med.navy.mil. Michael A. Matthias, UC San Diego — Medicine, La Jolla, CA, E-mail: mmatthias@ucsd.edu. Joseph M. Vinetz, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, CA, E-mail: jvinetz@ucsd.edu. Mayuko Saito, A.B. PRISMA — Biomedical Research Unit, Lima, Perú, and Universidad Peruana Cayetano Heredia — Department of Microbiology, Faculty of Sciences and Philosophy, Lima, Perú, and, Division of Infectious Diseases, Department of Medicine, University of California San Diego, San Diego, CA, E-mail: msaitop@gmail.com.

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